Revamped Cancer Agency Faces New Questions

Wayne Roberts is used to fielding tough questions about the $3 billion cancer-fighting agency he took over two years ago amid a full-blown crisis.

Roberts was brought in to stabilize the Cancer Prevention and Research Institute of Texas as the agency reeled from a scandal over its handling of research grants. He set about persuading legislators that a reformed CPRIT could again be trusted with public money, and state leaders eventually decided to let the cancer-fighting agency resume its efforts.

But now, as the reinvented CPRIT makes the case that its darkest hour has passed, its backers find themselves struggling to win over a new crop of staunchly conservative state lawmakers skeptical that the state should fund cancer research. CPRIT officials predict the agency will have spent about $1.5 billion, half its initial infusion of money, within two years. Some lawmakers are signaling that no more public money will be invested in the effort. 

“Those are legitimate, philosophical discussions, but they don’t have anything to do with respect to our operations,” Roberts said in a recent interview.

Lawmakers need to plan for a future when the agency could look radically different, said state Sen. Charles Schwertner, R-Georgetown, noting that state funding for the initiatives will dry up over the next decade. In one of Schwertner's first bills filed as chairman of the upper chamber’s Health and Human Services Committee, he called on the agency to develop a plan for “self-sufficiency.”

“I have my own concerns as to how involved the state should be in funding cancer research,” he said. “Maybe [CPRIT] was oversold and has under-delivered to some extent.”

Schwertner’s tenor differs markedly from his predecessor as committee chair, state Sen. Jane Nelson, R-Flower Mound, one of CPRIT’s most vocal champions. Schwertner’s bill has sounded the alarm among CPRIT devotees, signaling that the era of overwhelming support for the agency may be over for good.

And then there are reminders of the agency’s troubled past. Nary a committee hearing goes by without questions from lawmakers about the agency’s previous “issues.” Complicating matters is a Friday court date for ex-CPRIT official Jerry Cobbs, who is scheduled for arraignment in Travis County. Cobbs was indicted in 2013 on a felony corruption charge.

Lawmakers in coming years will decide whether the new-and-improved CPRIT proved itself a valuable investment. The initiatives funded by CPRIT, its advocates say, have saved thousands of lives — and given hope to countless others. 

“Personal biases as to whether or not he or she liked CPRIT in the first place should not be primary in the discussions” about the agency’s future, said state Rep. Jim Keffer, R-Eastland, a longtime agency proponent. “I think it’s the strongest it’s ever been under Wayne Roberts and the group he has.”

A Series of Setbacks

Before there was CPRIT, there was the publicity campaign.

When Congress was slashing federal funding for cancer research in 2007, state lawmakers drafted an ambitious proposal: The state would create an institute to end cancer, the complex family of diseases that claims more than 35,000 lives in the state each year — the No. 2 killer of Texans.

Cast in a leading role was legendary cyclist and seven-time Tour de France winner Lance Armstrong, who toured the state in a bus with a giant photo of his face plastered on the side — “Texans Curing Cancer,” the logo read — urging people to vote for the constitutional amendment authorizing CPRIT. A native Texan and a cancer survivor, Armstrong was an effective spokesman.

Proposition 15 passed with 61 percent of the vote, allowing the state to sell up to $3 billion in bonds and use the cash to award grants for cancer research and prevention.

“Here’s the deal: We cannot wait for Washington,” Armstrong said at a post-election celebration. “We need to take action, and we need to take action now.”

CPRIT would spend the bulk of its dollars on research and drug development. About 10 percent of the money would be set aside for prevention initiatives to reduce unnecessary deaths by more easily detectable strains. No plan was made for what happens after the initial pot of money is spent.

Five years later, the disgraced cyclist was stripped of his Tour de France titles amid a doping scandal that had poisoned his public image. Around the same time, an unrelated but parallel scandal unfolded around his signature cancer research initiative.

In 2012, a series of news reports detailed how CPRIT had awarded an $11 million grant to Peloton Therapeutics, a biotech company, without proper scientific review. It was reported that Peter O’Donnell, a major investor in Peloton, was also a major contributor to then-Gov. Rick Perry.

The Travis County public integrity unit, which polices public corruption, opened an investigation into CPRIT officials, including chief commercialization officer Cobbs.

State leaders placed a moratorium on new CPRIT grants in December 2012, and when lawmakers convened for the 2013 legislative session, they restructured the agency’s grant award processes and made changes to improve oversight and prevent conflicts of interest. In October, the moratorium was lifted.

Two months later, a grand jury indicted Cobbs on a felony corruption charge.

“It became a growing story, and there was a resulting loss of confidence in our processes by key members of the Legislature,” Roberts said of the entire ordeal.

But he was adamant that it was a thing of the past.

“I don’t think there’s a cloud over CPRIT, and I say that in all earnestness,” he said.

Prevention

Dana Anderson has always taken care of others.

Nearly a dozen years ago, she and her husband started the Light House – a ministry for troubled youth in Eagle Lake – 70 miles west of Houston. Then, about a year ago, she found herself needing help.

Anderson, who is uninsured, got out of the shower one day and noticed something wasn’t right. On the advice of a doctor, she reached out to The Rose, a nonprofit breast health care organization in southeast Texas, to schedule a free mammogram.

Anderson was diagnosed with breast cancer and found treatment through The Rose, which is funded in part with about $4 million in grant money from CPRIT.

As of Feb. 2015, CPRIT-funded services have detected 2,979 cancer precursors and 1,365 cancers, according to spokesman Jeff Hillery. Up to 10 percent of the money CPRIT awards each year funds preventive services.

But as lawmakers consider a future iteration of CPRIT, it is unclear what would become of the agency’s preventive operations. While cancer research in some cases could be developed into profitable drug treatments, it’s hard to imagine a scenario in which providing preventive services to low-income patients would be self-sustaining. 

“It’s a hope program to me,” Anderson said. “It says my life matters. It says that another person’s life matters enough to invest in something that is really pretty rampant in today’s world.”

What Comes Next?

Everyone on the Senate Health and Human Services Committee seems to agree that if Texas wants to remain in the cancer-fighting game, there needs to be a game plan.

That was made clear during a Feb. 21 committee hearing when Schwertner introduced Senate Bill 197, which directs CPRIT to create a plan to become financially “self-sufficient” by 2021.

“In the face of so many other competing funding priorities that legislators must consider, it is prudent for the institute to prepare to rely on other funding sources,” he said as he introduced the bill.

Roberts, in his testimony, said he applauded Schwertner’s bill because he said it was important for his agency to plan for the future. But so far, lawmakers have differing ideas about what sort of future they should be planning for.

One lawmaker wondered whether the bill was written as a kind of death knell for the cancer agency.

“I noticed that the American Cancer Society’s concern is maybe the purpose behind the bill is to shut down the agency,” said state Sen. José Rodríguez, D-El Paso.

Advocates for cancer research, testifying before the committee, spoke effusively of CPRIT's efforts but did not take a position on the bill, agreeing with Roberts that planning was "always a good thing."

State Sen. Judith Zaffirini, D-Laredo, found their neutrality hard to believe.

"Is that a very polite way of saying you really would rather be against [Schwertner's bill]?" she asked.

Cam Scott, the Texas government relations director for the American Cancer Society, paused before answering. He said he had gotten "mixed messages" about the bill's intent.

Now the question is whether that "politeness" will last.

This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.